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Hyperandrogenism can cause hair fall in women as it disrupts the normal hormonal balance. This medical condition can also cause symptoms like acne, hirsutism (excessive hair growth), and irregular periods. Hyperandrogenism results from a higher-than-usual level of the androgen hormones in the body. One of the primary causes of hyperandrogenism is polycystic ovarian syndrome (PCOS), although there may be other causes, like adrenal issues or benign tumours that cause the body to produce excess androgens.
The most common androgen hormone is testosterone, responsible for the development of male characteristics during puberty. While not at the same levels as men, women also produce testosterone in their ovaries and adrenal glands. This hormone helps develop muscle and bone strength and regulates mood and libido.
Understanding the symptoms and hyperandrogenism causes can help you identify this condition and get the right treatment to prevent hair fall and other symptoms.
What is hyperandrogenism?
When the body produces too much of the androgen hormones, it causes a condition called hyperandrogenism. Your body runs like a well-organised factory. Each system plays its part to make sure that all functions are normal. Your hormones are like messengers that carry signals throughout the body, informing systems when to increase or decrease functions, or even to take a break.
Excess androgen hormones send wrong signals to the systems. So instead of building the normal amount of muscle and keeping facial hair at a minimum for women, the body thinks it has to do things differently. The excess of one hormone also tends to suppress other hormones, so they can’t get their messages out as they’re supposed to. As you can see, this can wreak havoc with the normal workings of your body.
Hyperandrogenism can affect both men and women, but symptoms are more noticeable in women as they can experience an increase in facial hair while the hair on their heads starts to thin; things normally seen as male characteristics. Hyperandrogenism is generally caused by other conditions that increase the production of these little messengers. Let us understand these causes better, which is the first step to effective treatment.
Causes of hyperandrogenism
As briefly mentioned above, hyperandrogenism is the secondary effect of another condition; let’s take a closer look at these conditions.
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PCOS
About 70-80% of hyperandrogenism cases in women are caused by Polycystic Ovarian Syndrome (PCOS). PCOS is like accidentally leaving a tap open, so the bucket overflows and there’s too much of one type of hormone. In this case, it is the hormone that triggers ovulation during a woman’s menstrual cycle. Because everything is so well-connected in the body, an excess of one hormone can affect the levels of other hormones and result in hyperandrogenism.
The hormonal changes caused by PCOS can also affect your hair and skin, but luckily, there are treatment options that can help strike a balance between the various hormones and support your hair health.
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Androgen-secreting tumours
Tumours of the adrenal glands, ovaries and testes can also produce an excessive amount of androgens. Though not very common, hyperandrogenism caused by these types of tumours can occur very suddenly and show symptoms.
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Cushing disease
Cushing disease is a condition where a non-benign tumour on the pituitary gland causes an increase in cortisol levels in the body. Cortisol is the stress hormone and affects the adrenal glands, causing them to produce excess androgen hormones. The increased cortisol can also lead to weight gain, seen in hyperandrogenism.
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Congenital adrenal hyperplasia (CAH)
CAH is a hereditary condition caused by certain genes that do not function properly. This condition results in lower levels of enzymes required to make hormones. The hormonal imbalance then leads to excess androgen production. It’s similar to a seesaw, where the imbalance of hormones causes androgens to go up.
Several conditions can result in hyperandrogenism. Certain medications, like anti-seizure medication and steroids, can also cause hyperandrogenism as a side effect. It is therefore very important to give your doctor your complete medical history when getting a diagnosis for hyperandrogenism.
Symptoms of hyperandrogenism
Hyperandrogenism symptoms depend heavily on whether you have attained puberty. Some common symptoms include oily skin, acne and excessive hair growth throughout the body. Let’s understand the symptoms of hyperandrogenism in adult men and women better.
Hyperandrogenism in men
While hyperandrogenism can cause early onset of puberty in young boys, physical symptoms are not very obvious in men who have already undergone puberty. Rare testicular tumours (like Leydig cell tumours), adrenal gland disorder, and abnormally high levels of dihydrotestosterone (DHT) can cause hyperandrogenism in men.
The hyperandrogenism symptoms include -
- Severe acne
- Hair fall
- Excessive body hair
- Enlarged prostate
- Infertility
- Lower sperm count
Hyperandrogenism in women
Hyperandrogenism in women has more obvious and visible symptoms as it causes certain male features. These hyperandrogenism symptoms include:
- Excess facial and body hair that is thick and coarse (Hirsutism)
- Irregular or no periods
- Hair thinning on the crown of the head
- Male pattern weight gain around the abdomen
- Hair thinning at the crown
- Oily skin prone to acne
- Clitoral enlargement
As in men, hyperandrogenism can also cause infertility in women due to the disruption of the normal female hormone cycle.
Treatment of hyperandrogenism
Treatment of hyperandrogenism is like providing the right conditions for your garden to grow. Just as you need sunlight, good soil and the right amount of water for plants to thrive, similarly, your body also needs the right nutrients and lifestyle conditions to function at its best.
Just like in the case of hair fall, if a plant is losing leaves, you first need to find the cause so that you can treat it and then nurture your plant back to health. Finding the cause of hyperandrogenism is the first step to restoring your hair health. Therefore, when you visit your doctor for hyperandrogenism symptoms, they will first ask for your complete medical history. This will include:
- At what age did you attain puberty?
- Do you currently have any other illnesses, or did you recently recover from one?
- Are you currently taking any medication?
- What is your family’s medical history?
- (If you’re a woman) Is your menstrual cycle regular, or are you experiencing any irregularities?
- (If you are married) Are you facing any problems with infertility?
The doctor will then also ask you to have blood tests, which can check the levels of various hormones in your body, especially testosterone and other androgen hormones. A higher level of these hormones is a clear sign of hyperandrogenism. However, higher levels of hormones like cortisol and insulin can also point to other conditions which cause hyperandrogenism.
Once the cause is determined, the doctor can decide on a course of treatment. Hyperandrogenism treatment is two-fold. Both the cause and the symptoms need to be treated.
- Hormone treatments to make sure you have the right number of messengers in your body, and they are all doing their job properly.
- Steroids and hormonal birth control pills can help certain messengers from playing pranks on the body.
- Intermittent fasting, which follows the 16/8 method (16-hour fasting/8-hour eating window), can significantly help lower insulin levels and also lower androgen levels in the body. This method has been found to reverse symptoms like acne, hirsutism, and stabilise the menstrual cycle. This is like ensuring your garden doesn’t get too much sunlight or water because that can also affect plant growth.
- PCOS medications and type-2 diabetes medications can also help maintain normal hormone levels in the body.
If hyperandrogenism is caused by a tumour or tumours, surgery might be required to remove the growth. As these tumours are often benign or non-cancerous, treatments like chemotherapy and radiation are not required. Following your doctor’s orders and being consistent with your treatment will give you the best chance at a full recovery.
The second course of action is treating hyperandrogenism symptoms, like oily skin, acne, excessive hair growth and hair thinning. In many cases, treating the cause can also reverse the secondary physical symptoms. However, if required, a dermatologist can prescribe topical treatments for acne and oily skin.
Hyperandrogenism in women may seem daunting initially, but it can be effectively managed with the right care. If your hair seems to be thinning over time due to hyperandrogenism, try to look at it as a sign that things are a little off-balance in your body. The right treatment will help to get things back on track so that, in time, your hair will start to look healthy again.
Aside from taking medication, you can also apply topical minoxidil and take Traya’s hair growth supplement to give your hair an added boost. A high-protein diet, as well as vitamin and mineral supplements, can also help your hair grow back. Your hair is like a garden that will thrive when it receives the right nutrients and sufficient water. Aside from these factors, managing your stress levels, incorporating a balanced diet, and maintaining a proper sleep cycle make a huge difference to your hair health. However, it is important to follow your doctor’s or dietician’s instructions and be patient.
Other hyperandrogenism symptoms, like excessive hair growth on the face and body, can be managed through methods such as shaving, waxing, or even laser hair removal. You can talk to a dermatologist to determine the best course of action for your case. The key is not to give up. Give yourself the time and space you need to heal and recover. A little patience and consistency can go a long way in treating hyperandrogenism and its symptoms.
Frequently Asked Questions
1. Is hair fall from hyperandrogenism permanent?
In most cases, when treated early, hyperandrogenic hair fall can be completely reversed. It is important to see your doctor and get tested as soon as you start to notice symptoms. Hair fall in women is generally seen as thinning on the crown of the head, but the hair can grow back with the right treatment. Delaying treatment may worsen the condition.
2. Can a woman with hyperandrogenism get pregnant?
Hyperandrogenism can cause infertility because it disrupts the normal levels of sex hormones in the body. One of the main causes of hyperandrogenism in women is PCOS, which can also lead to fertility issues. Therefore, a woman may have difficulty getting pregnant if she is suffering from hyperandrogenism.
3. How dangerous is hyperandrogenism?
Hyperandrogenism by itself is not a life-threatening condition. However, if left untreated, it can affect quality of life and lead to problems like diabetes, difficulty with conception, metabolic syndrome, and cardiovascular disease. Acne and excessive facial hair can also impact confidence and mental well-being.
4. Is there a cure for hyperandrogenism?
There is no direct cure for hyperandrogenism, but the underlying cause can be treated. Medications can help maintain the correct hormone levels in the body and reduce symptoms. In some cases, such as Cushing disease, surgery may help eliminate hyperandrogenism completely once pituitary gland function returns to normal.
5. Is hyperandrogenism connected to type 2 diabetes?
Yes, hyperandrogenism and type 2 diabetes are interrelated. Higher androgen levels in the body can lead to insulin resistance, which may cause diabetes. Similarly, increased insulin levels can reduce the production of enzymes that help control testosterone levels, which can further contribute to hyperandrogenism.
6. What kind of diet and lifestyle can help manage hyperandrogenism?
Since hyperandrogenism is usually caused by an underlying condition, prevention can be difficult. However, in conditions like PCOS or diabetes, lowering insulin levels can help control symptoms. A low-sugar, high-fibre diet may help keep insulin levels balanced and reduce inflammation. An active lifestyle that supports a healthy weight can also improve symptoms. A high-protein diet may support hair recovery while receiving treatment for hyperandrogenism.
References:
- https://pmc.ncbi.nlm.nih.gov/articles/PMC8548673/
- https://dermnetnz.org/topics/hyperandrogenism
- https://pmc.ncbi.nlm.nih.gov/articles/PMC10099172/#:~:text=Abdominal%20obesity%20is%20associated%20with,excess%20must%20be%20ruled%20out.
- https://cosmoderma.org/unmasking-hyperandrogenism-what-clinical-symptoms-reveal-about-hormonal-mysteries/
- https://www.pcds.org.uk/clinical-guidance/hyperandrogenism
- https://pubmed.ncbi.nlm.nih.gov/12399766/
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